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SPECIAL EVENT LIABILITY GROUP INSURANCE TRUST DATE <br /> CERTIFICATE OF INSURANCE ENDORSEMENT 8/8/2024 <br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, <br /> EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE ENDORSEMENT DOES NOT CONSTITUTE A CONTRACT <br /> BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. <br /> PRODUCER: CONTACT NAME: JOY CUMMINGS <br /> HUB International Insurance Services Inc. PHONE 925 609 6500 FAX 925 609 6550 <br /> 3000 Executive Parkway,Suite 300 EMAIL specialevent(a)hubinternational.com <br /> San Ramon,CA 94583 INSURER(S)AFFORDING COVERAGE NAIC# <br /> CA License#0757776 INSURER A: Colony Insurance Company 39993 <br /> NAMED INSURED: <br /> City of Santa Ana <br /> 20 Civic Center <br /> Santa Ana, CA 92701 <br /> COVERAGES <br /> This is to certify that the policies of insurance listed below have been issued to the insured named above for the event date(s)indicated below. Notwithstanding any requirement,term or <br /> condition of any contract or other document with respect to which this certificate may be issued or may pertain,the insurance afforded by the policies described herein is subject to all the <br /> terms,exclusions and conditions of such policies. <br /> INSURED MEMBER <br /> INSR COVERAGE EFFECTIVE <br /> TYPE OF INSURANCE ENDORSEMENT / LIMITS <br /> LTR NUMBER EXPIRATION DATE <br /> A GENERAL LIABILITY EACH OCCURRENCE $1,000,000 <br /> X COMMERCIAL GENERAL LIABILITY 41511 08/11/2024 DAMAGE TO RENTED PREMISES $1'ooa'000 <br /> (Ea occurrence) <br /> CLAIMS-MADE ❑X OCCURRENCE MED EXP(Any one person) $5,000 <br /> PERSONAL&ADV INJURY $1,000,000 <br /> GENERAL AGGREGATE $2,000,000 <br /> PRODUCTS-COMP/OPAGG $2,000,000 <br /> LIQUOR LIABILITY PER <br /> OCCURRENCE(AGGREGATE <br /> INCLUDED IN GENERAL LIABILITY n/a <br /> AGGREGATE) <br /> MASTER POLICY#103 GL 0021111 -EFFECTIVE DATE 1/1/2024; EXPIRATION 1/1/2025 <br /> DESCRIPTION OF OPERATIONS/LOCATIONS <br /> City of Santa Ana,its officers,officials,employees and volunteers,20 Civic Center Plaza,Santa Ana,CA 92701 <br /> is/are included as an additional insured(s)per attached endorsement T5409-0118.Policy is Primary and Non-contributing per attached endorsement T1095-0108;Waiver of <br /> Subrogation applies per attached endorsement CG 24 04 05 09. <br /> Event Type: Festival/3vs3 Basketball <br /> Event date(s): 8/11/2024 <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED <br /> BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> ACCORDANCE WITH THE POLICY PROVISIONS. <br /> City of Santa Ana,its officers,officials,employees and volunteers,20 Civic Center Plaza,Santa Ana, AUTHORIZED REPRESENTATIVE <br /> CA 92701 <br />